Epidemic Cholera in Trujillo, Peru 1992: Utility of a Clinical Case Definition and Shift in Vibrio cholerae O1 Serotype

Duc J. Vugia Foodborne and Diarrheal Diseases Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Regional Health Department, General Office of Epidemiology, Ministry of Health, Hospital Belen, Hospital Regional, Atlanta, Georgia, Peru

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Marcela Rodriguez Foodborne and Diarrheal Diseases Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Regional Health Department, General Office of Epidemiology, Ministry of Health, Hospital Belen, Hospital Regional, Atlanta, Georgia, Peru

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Rodolfo Vargas Foodborne and Diarrheal Diseases Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Regional Health Department, General Office of Epidemiology, Ministry of Health, Hospital Belen, Hospital Regional, Atlanta, Georgia, Peru

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Carlos Ricse Foodborne and Diarrheal Diseases Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Regional Health Department, General Office of Epidemiology, Ministry of Health, Hospital Belen, Hospital Regional, Atlanta, Georgia, Peru

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Cecilia Ocampo Foodborne and Diarrheal Diseases Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Regional Health Department, General Office of Epidemiology, Ministry of Health, Hospital Belen, Hospital Regional, Atlanta, Georgia, Peru

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Rocio Llaque Foodborne and Diarrheal Diseases Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Regional Health Department, General Office of Epidemiology, Ministry of Health, Hospital Belen, Hospital Regional, Atlanta, Georgia, Peru

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J. Luis Seminario Foodborne and Diarrheal Diseases Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Regional Health Department, General Office of Epidemiology, Ministry of Health, Hospital Belen, Hospital Regional, Atlanta, Georgia, Peru

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Katherine D. Greene Foodborne and Diarrheal Diseases Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Regional Health Department, General Office of Epidemiology, Ministry of Health, Hospital Belen, Hospital Regional, Atlanta, Georgia, Peru

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Robert V. Tauxe Foodborne and Diarrheal Diseases Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Regional Health Department, General Office of Epidemiology, Ministry of Health, Hospital Belen, Hospital Regional, Atlanta, Georgia, Peru

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Paul A. Blake Foodborne and Diarrheal Diseases Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Regional Health Department, General Office of Epidemiology, Ministry of Health, Hospital Belen, Hospital Regional, Atlanta, Georgia, Peru

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Epidemic cholera continues in Peru. Since 1991, cholera surveillance in Peru has been based mainly on clinical recognition. To determine the proportion of reported cholera patients who actually have cholera and to evaluate the clinical case definition used in surveillance, we cultured rectal swabs from patients presenting with acute diarrhea in March 1992 in Trujillo, Peru. Of 197 patients meeting the clinical case definition, 174 (88%) had confirmed Vibrio cholerae O1 infection. In this epidemic setting, watery diarrhea of sudden onset in a person of any age presenting for treatment is highly predictive of cholera. Of note, 90% of the current V. cholerae O1 El Tor isolates were of serotype Ogawa, while a year earlier, all were of serotype Inaba.

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